This week’s Medicare updates include two new advisory opinions; updates to the Physician Compare, Long-Term Care Hospital Compare, and Inpatient Rehabilitation Facility Compare websites; a republished version of the OPPS final rule to include a previously omitted section, and more!
Most physicians are familiar with the MIPS quality models: These are the Physician Quality Reporting System (PQRS) measures that we’ve been reporting for years with the old Medicare value-based purchasing program. What we don’t know much about are the new cost efficiency models in MIPS, which are based solely on hospital and physician ICD-10-CM/CPT claims data rather than a clinical abstraction of our medical records.
The general rules for security, risk analysis, and risk management implementation specifications, and evaluation standards are key directives for ongoing compliance assurance. Although risk analysis concepts guidance appears in the Security Rule, many organizations use it for auditing Privacy Rule processes as well.
The comprehensive population health program at Northern Arizona Healthcare in Flagstaff didn’t come together overnight. Rather, it evolved over time, relying on trial and error to fill the care gaps that so often result in avoidable hospital readmissions.
Q: Our facility does not often use open-ended queries to physicians. Could you give an example of an open-ended query and any disadvantages they may have?
Q: We see many assertions that encryption at the right level meets the National Institute of Standards and Technology (NIST)/HIPAA safe harbor provision with no explanation of what is necessary to prove the breached electronic protected health information (PHI) was actually encrypted at the moment of breach. How can a covered entity prove the PHI was actually encrypted at the time of the breach?
